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Friday, March 22, 2013

This evening the four Kenya Myhres will board an airplane for Dulles Airport in Virginia. We will reach our 20-year-milestone of Africa service this year. And for all those 20 years, 118 Lake Drive in Sterling has remained our stateside home base. This was my home through half my childhood, and my mom has lived there for 40 years. We have fled there with practically nothing (a cardboard box tied with string of the hand-me-downs given after a war drove us out). We have celebrated births (Julia's) and mourned deaths (my Dad's) within those walls, concocted meals on that screened porch, squeezed cousins and kids into those beds, watched slides, decorated for Christmas, played ping-pong, read and worked on those tables. It's only a ten minute drive from Dulles, an easy place to access from overseas, and less than half an hour from the church to which we all belong and which remains our stalwart of support.

But this home has become too much for my mom to manage alone, and without us nearby to help her, she has decided to sell and move nearer to my sister in Charlotte.

So this tacking-point of stability is about to be pulled out. I'm sure we won't even realize how much we counted on 118 Lake Drive as a foundation until it is gone.

As a final moment of grace, God allowed Caleb's Spring break to overlap with my sisters' kids vacation, with Easter weekend, and with my mom's plan to put her house on the market, so we will all converge to reminisce and clean and pack and sort and throw away. And to celebrate Easter together, a rare event.

We personally have WAY TOO MUCH accumulated detritus of decades, shoes we thought we'd need again, sweaters, photos, the kind of thing that is not practical to pack in a suitcase for Africa but also hard to toss, tucked under beds and in the tops of closets or boxed in the basement.

So pray for wisdom in what to do with things. Courage to let go. The right balance of sentiment and practicality. Sensitivity to each other. Sheer determination to get it done. We so rarely help my mom with much of anything we'd like these two weeks to be a blessing to her.

Another step in the journey of being at home all places and no place, of longing for eternity, of finding a balance between modeling the heavenly mansion and yet being willing to let go of any claim to such security on earth.

Thursday, March 21, 2013

In the last week, as a mom of teens nearing the end of term, I have proofread thousands and thousands of words of research papers on: AIDS (the reasons for resurgence in Uganda, response); Louisa May Alcott (post-transcendentalist nature); Food Irradiation (safety?); Terrorism (to negotiate or not); and Globalization (is it ruining our world?).

In the spirit of the last one, a tale of the beauty of globalization.

Scott discharged a patient yesterday. He was a teenager growing up in Somalia, where the infrastructure of life has been decimated by war. So he was sent to secondary school in Tanzania, where he became quite ill. He travled to a hospital in Uganda where he was diagnosed with TB, but after failing to improve on his medicines, he quit taking them, and went to Nairobi where he has cousins. After a long hospitalization at a private hospital with dwindling health and on the point of death, he came to Kijabe which is well known and trusted in the Somali refugee/exile community. Scott and others puzzled and probed and spoke often on the phone with his brother in OHIO who had funded twenty thousand dollars worth of care so far for naught. Meanwhile the best speakers of his native language and patient advocates here are Germans who visited and prayed. Scott was able to connect with two French doctors working for MSF who have a lab that tests for drug-resistant TB, and made the diagnosis that this teen's problem was indeed very serious, life-threatening TB which was "MDR", multi-drug resistant. The MSF team of Somali-Kenyans came out to Kijabe with specialized hard-to-access drugs. A few weeks later this teen was walking, talking, laughing, alive, on his way from skeleton to healthy young man once again. The brother in Ohio wired the modest hospital fees to Kijabe (compared to the previous outlay) and he was discharged into the care of the Nairobi cousin and the MSF clinic in town as an outpatient. Everyone is rejoicing.

That's more than a half-dozen countries all coming together to save this kid's life. And I suspect that this story is not over, more will be written.

Globalization CAN be beautiful.

PS. Here is the Nursing Director for all of South Sudan visiting Kijabe where she is working with an American anesthesiologist in a Kenyan program to train the new country's first dozen Registered Nurse Anesthetists. Case in point.

Sunday, March 17, 2013

Last time we were in the States we had a slide show to the tune of "hold on, to the One who's holding you . . ." Because holding on seems to be about as much as we can manage, and even that is only possible because we're held.

This has not been an easy term. Life seems to escalate week by week, and we've found ourselves way too scattered. This weekend has been a welcome respite of breathing space, and offered some reflection on survival.

So I offer these holding-on points.

First and foremost, transformation from within, which if you read this sign you'll see is the theme for the year for Kijabe hospital. This was from last week's chapel. I'm reading, slowly, Practicing the Presence of God, by Brother Lawrence. I've become harried and distracted and not very nice a lot of the time. I need a heart that dwells with God to hold on through the days.

Second, thankfulness. As I rush back and forth from hospital to home I have been trying this week to call to mind something to be thankful for. I think I'm like this preterm baby (born in a car, but doing quite well). I think my little incubator world is all there is, and take for granted that someone will provide all the necessities of life from outside. But one day this baby will leave his box, and one day we'll see the reality of eternity and how limited our view was in expecting all our needs to be met. So I'm trying to remember to practice thankfulness.

Third, sharing the battles. This is Erika, treasure hunting. As in cleaning out boxes of disorganized medical supplies to find the treasures therein. To hold on requires friends, and she has been a great friend these last six months. Last weekend I was on call and it just felt like everything fell apart. The monitors were beeping without stop, the nursing staffing was inadequate, the casualty paged the wrong numbers for a code, a crib we sent for repair came back still in dangerous condition, I went to a delivery for a baby with meconium and the proper equipment was missing (the baby was fine), and on and on. Monday I said to Erika, I can plow through the details of the medical care for these 20 or 30 babies, or I can fight the long-term battles of organization and equipment and nursing and politics. But I really don't think I can do both.

Her own departure had been successfully delayed by two weeks (YEAHH). So as I did rounds this week, in she came to plunge into all the other muck. Lo and behold, she got these guys from biomed to come in and fix the lights on our warmers. I got the nurses to replace all the monitor probes, and when one baby's jaundice just wouldn't improve we got that light changed too. We met with the nursing director yet again about staffing. Erika found TWO of the small missing pieces of suction equipment I needed. She's made tremendous progress on locating a piece of lab equipement within the realms of possible fund-raising affordability that would greatly improve care. And on and on.

The point is, the battle is a strenuous and unending one, and we all need champions. I'm thankful for our tremendous paeds team.

Fourth, family. Mine are an anchoring reality of love and belonging. Here is Julia with the girls' varsity soccer team at our house for their end-of-season pizza party. She was given the "St Peter Award", for being a key ROCK on which the team was built.

My rock is Scott, and I am blessed by all my kids.

(Jack's friends Rich and Ali "helping" him with a homework problem while Acacia looks on)

And speaking of thankfulness AND family, here is Caleb at the Recognition Dinner, the milestone of making it through the 9 months of being a first year cadet and being fully accepted into the USAFA. We are very very proud of his perseverance through difficulty and of the hard work he's put into school and into his physical therapy for healing his knee.

Lastly, nature. There is something about a hike that restores the soul. Acacia gamely went on a long wander with me this week, climbing the ridge above the school on newly forged paths. We almost got lost, but we managed to find our way back eventually. The scramble, the breathlessness (me), the sunshine, the happy dogs, the forest, the Longonot view, the refreshing absence of noise and people and instead the peace of the woods and wind.

So, inner spiritual strength, thankfulness, shared battles, the foundation of family, and hours in nature. Five ways to hold on.

Friday, March 15, 2013

Then shall be brought to pass the saying "Death is swallowed up in victory." O Death, where is your sting? (1 Cor 15:54-55)

Our community is feeling the sting, even though we wait for the swallow of victory.

And from a source we don't usually count in our top ten Africa worries. Cancer.

As I write, two women in my age range, both former missionaries here who are wives of former Kijabe doctors, are dying of metastatic breast cancer in the US. Both are surrounded by friends and family, both have passed beyond the possibility of anything but an 11th hour miracle to delay their final journey. Both are women of faith who will leave behind teens and older kids who still need them, much as Betty Heron did over 12 years ago.

As I write, I know of a team of 20-30 somethings with the second diagnosis of cancer in two years. This is a small team. This is a relatively cancer-free age group. Both were diagnosed because of persistent symptoms that may or may not have been related directly to the cancer, but led to life-saving investigation. Both should recover with surgery and medical care, but not before a road already marked by suffering becomes a lot harder. And not before the people they went to serve miss them, terribly.

As I write, a family from the other major mission hospital in Kenya holds a memorial service for their 13 month old daughter who died from a brain tumor. She went into cardiac and respiratory arrest Tuesday night, had a CT scan revealing a large aggressive mass, and was brought in critical condition to Kijabe on Wednesday for surgery. Her family had only arrived in Kenya five weeks earlier, a doctor dad and a mom with 3 boys and this little girl who kept vomiting. Their eloquent journey of faith is told here: http://www.aaroninkenya.com/. In spite of excellent surgical and ICU care, we could not reverse the damage this tumor had already done, and she died yesterday morning. This dad's blog response is absolutely worth reading.

That's five saints in a week, ages 13 months to 50-something, one dead, two dying, and two figuring out life with surgery and chemo and radiation and delays.

Which just reminds us that this world is a broken place, where innocent people are caught in the crossfire of evil. But where community and love and prayer and hope bring beauty all the same.

I'm way on the periphery of all these stories, praying for the ladies with breast cancer in my Thursday prayer group, emailing and talking with missionaries on distant teams, and helping coordinate and mobilize the less-then-24-hours of intense effort for the toddler. When she arrived in a flurry of doctors from her own mission hospital and our normal ICU staff, I could see pretty quickly that extra hands were not needed. So when the surgeon asked for a donor for O+ blood, I jumped on giving the one thing I could offer.

Which wasn't enough.

But which symbolizes pretty powerfully all we do, be it prayer or diagnosis or surgery or baking or driving or fundraising. It's our life, our blood, sweat, and tears, pouring out for redemption, an imitation and partnership with Jesus.

Because God didn't rewind the world to erase evil. And He doesn't stop evil on every front at every moment. But by the blood and by word (Rev 12:11) we are part of that death-swallowing victory, the one that overcomes evil in the end, that writes a good ending to all these stories that look pretty dismal at the moment, that transforms five cancers into a weight of glory.

Because when a political regime changes, life becomes unsettled, and a vision of God becomes more necessary.

This is the year that President Uhuru Kenyatta won. And it has been an unsettling time.

The election was held a week ago, with long lines and optimism, with correspondents snapping colorful photos of the Africa people in the West want to see: beaded maasai women clustering and queuing, or slum residents loitering outside shops waiting for news. For about a day the results were steadily flowing in and being broadcast, and we all thought the new era of responsible management had begun.

Only then it became apparent that the lap-tops being used to power identification programs (fingerprints) and the cell network being used to report results, weren't working. Polling stations were in schools, and whoever designed the program failed to take into account the lack of electricity in most schools. The election monitors were taksed to bring the ballets back to their NBI headquarters. The initial tally was re-counted. Some of the monitors failed to show up, for days. The entire excruciating process dragged on from Tuesday through Saturday. Britian "happened" to land troops for a training exercise. Kenya was getting restless. Friday we expected the announcement, and Friday night went to bed still uncertain. The winner would have to get 50% PLUS a minium of 1 vote more, AND garner at least 25% in more than half of the 47 counties. We heard about police officers being killed by a mob on the coast, but the week was mostly tense and surreal, with verbal arguments but commendable restraint. A LONG, long wait and see.

On Saturday morning we were awakened at 5 a.m. by shouts, screams, horns, whistles and drums. It seems the unofficial tally was complete, and Uhuru Kenyatta was the winner with 50,07% of the vote. His ethic background is similar to that of our neighbors, so they were ecstatic. I peaked out the window, fairly certain this was happiness (vuvuzelas for instance) but equally aware of the potential for violence. Masses of people marched in the darkness in front of our house, their dusty coats or huddled shoulders visible in the car headlamps which followed each section of humanity. They were ululating, screaming, whistling, dancing. There would be a group, then a car, then more marchers, then more cars. They were celebrating, but the line between a victorious throng and a mob seemed small in the darkness.

Seven hours and one patient-death later, we were back around the TV on a Saturday afternoon, waiting for the 11 am official announcement. Three hours of commentary, music, crowd shots, false starts, suspicious pauses, announcements later, we finally saw the chairman of the IEBC (electoral commission) take the podium. "There can be victory without victims," he said. Kenyatta was declared the winner.

The runner-up, Odinga, with 43% of the vote, immediately filed a petition in court. There were a few protests in his western strongholds, and in a crowded central Nairobi slum. But no eruption of widespread unrest. The police waited. The people waited. And not much happened. Today we're all breathing a collective sigh of relief. The sun is shining, the schools reopened, groceries are once again on the agenda, the hospital clinics are full.

Kenyans showed that history does not have to repeat. Our chaplain this morning commended the "hakuna haraka katika Africa" (no hurry in Africa) attitude of Kenyans as we spent six days in suspense, allowing the tedious process to be carried out. This election is seen as a triumph of democracy, at least by those who won of course, but I think by the world in general. It is also seen as a triumph of Africans refusing to bow to pressure from the West. What Americans see as a moral issue (the ICC vs. Kenyatta) Africans see as a sovereignty issue. When the US issued a veiled threat that the people should not choose Kenyatta, it only seemed to boost his ratings. Here is a summary from the news:

In his victory speech, Kenyatta said: Today, we celebrate the triumph of democracy; the triumph of peace; the triumph of nationhood. Despite the misgivings of many in the world, we demonstrated a level of of political maturity that surpassed expectations. That is the real victory today. A victory for our nation. A victory that demonstrates to all that Kenya has finally come of age. That this, indeed, is Kenya's moment." He also pledged to work together with his political opponents with "friendship and cooperation." "Kenya needs us to work together," he said. "Kenya needs us to move on." In a pointed warning to the international community, he added: "We expect the international community to respect the sovereignty and democratic will of the people of Kenya. The Africa star is shining brightly and the destiny of Africa is now in our hands."

And so the next era of Kenyan history begins, mostly with hope, though of course there is frustration and skepticism mixed in too.

Isaiah reminds us that the political regime may change, but God is still on the throne. The last month has been a trying one as we've wondered if the entire country would fall apart, would we evacuate, what dangers lay ahead. As the patients trickle back, I am beginning to see this took more than just an emotional toll. Kids are presenting who have been sick for days or weeks, only their families feared travel to the hospital. One came too late, and died just as he was arriving yesterday. I need an Isaiah view of God, a new vision of repentance, purpose, hope.

Isaiah 6 ends with the holy seed, the offspring from the burned stump, the post-judgment promise of renewal. We long to see that day when Jesus' rule drives out fear and death and sorrow and injustice. When we can celebrate much more than a new president, a new Heavens and a new Earth.

Thursday, March 07, 2013

In honor of International Women's Day, I salute our Paeds team. Bob and Rick missed this snap on Wednesday so it truly was an all-women team.

I'm privileged to work with this group. Next to me is Clinical Officer (PA) Veronica, who made the difficult and agonizing decision to forgo a job in Nairobi that paid almost twice the salary because she was committed to the needier patients here. She's the core of our nursery team now, and hopes to serve the disabled neurosurgical kids for many years. Next to her is Dr. Ima, and in the green scrub shirt Dr. Sarah. These two finished masters in Paediatrics at the University of Nairobi/Kenyatta program, and returned to work at Kijabe with their surgeon husbands. They are brilliant and caring and I learn from them every day. In the center is Dr. Erika, who once upon a time was a medical student and intern when I was a resident in Chicago, and now is a successful neonatologist and researcher who came to boost our education and effort for six months. And on the far right another Dr. Sarah, who shares a position with her paediatrician husband Dr. Rick, here for two years from North Carolina, and impossibly tasked with improving our radiology department on the side.

I salute my own daughter, whom I learned after-the-fact led the RVA students in prayer chapel yesterday, and preached from Romans 13 exhorting her peers to speak with due respect of whomever is elected in Kenya, particularly when talking about elections with Kenyans. Wise words from an emerging woman who is a leader I would follow.

And on this day I always salute one of my personal friends and heroines, Melen Musoki, wife of the late Dr. Jonah Kule. Because on March 8 2008 she gave birth to her sixth child and first son, Jonah Muhindo, three months after being widowed by ebola. I remember that night at the health center, the fellowship of the women there, the bittersweet joy of this son. Melen is a woman of courage and perseverance who has steered her brood through many trials, founded a nursery and primary school, and held firm to the vision she shared with her husband.

And lastly on this day I salute the mothers of my patients (see yesterday's post) whose hearts break for their vulnerable little ones, who cradle them through fevers and convulsions and diarrhea, who sacrifice to bring them to help. Working with these women is an honor. Baby Z stayed with us for over a month, and when she went home this week, her mom called to me from the roadside where she was waiting for a matatu and I was walking to my house. "Jennifer!" she yelled, and I looked to see who might know my name. She just wanted to say thank you, again. Z had come in with fevers and subtle convulsions, and it took some persistence and detective work to figure out she had TB meningitis. It was touch and go for a while. Now instead of being dead, she's beautiful and vigorous. And her mom is so grateful and relieved.

Women reflecting God, in leading and caring and serving. Happy International Women's Day!

This week I returned to the Nursery Service, which is now officially an NICU. I love the tropical steaminess of that cluttered room where we incubate tiny babies and fuss over their ten gram growth spurts. There are panic codes, "999" pages for which a run and timely intervention can literally mean the difference between life and death. Yesterday one of those saw me in the delivery room where a mother was grabbing my neck and pulling my hair in agony as the midwife and I supported her on each side and both kept up a constant "push, push" chatter stream, nervously listening to her baby's heart rate ominously slowing. Then in the miracle that never, ever, gets old, a squished curly-haired head finally emerged, followed quickly by a slippery grey body, and before we could even lift her to the resuscitation table she was squalling. Alive.

While the rest of Kenya holds their collective breath, stores closed, kids home from school, idle and restless . . . the babies keep coming. In a pre-election purge almost all my paediatric patients had gone home, but then I switched to nursery where birth takes no holiday.

There is plenty of heartache in the NICU, plenty of loss, as the most dangerous days of a person's life pass by (the first few for a baby, and the one in which a woman endures labor for a woman).But there is also the potential for cure, for life, for revived breathing and a long life. And it is often very hard to tell which babies will be in danger, and which will thrive. So we try to give all of them a fighting chance.

The fighting chance can drag on, week by week, for babies with severe birth defects perhaps, or extreme prematurity. So I found a few babies on my service who had been percolating for weeks. One had a ballooning head. One was born with no eyes at all, just slits covering a few membranes. One is spastic and fussy. And one has such a list of complications he could be a live textbook: a mis-shapen skull, an abnormal brain, holes in his heart, and on and on. Baby E is just plain peculiar looking.

To me.

But not to his mom. She labors over his feeding. When we told her we had to do some tests to investigate his fever, she got tears in her eyes anticipating his pain. She holds him, washes him, loves on him. As do almost all the mothers of babies that would make you gasp, or politely avert your eyes.

Beauty is a quality they see, because they have lenses of love.

As I was mulling over this with a colleague, she agreed, and took it a step further. Because their mothers find them beautiful, we start to do the same. A loved baby starts looking lovelier. And that love-tagged value keeps us fighting for these little ones.

I know, because I feel the same about my kids. Caleb is in a 48-hour period now of the final-push of abuse and trial, mental and physical, before the first year class reaches the milestone of "recognition" on Saturday. Relative to the Air Force, he's a disabled child, down to one crutch but still limping along in a brace with a hard road ahead. Please pray for him. To me he's beautiful, as are Luke, Julia, Jack and Acacia, no matter what they have to go through, I'm on their side.

So I try to be on Baby E's side too, joining his courageous mother to hedge him from harm and keep him firmly amongst the living. Because he's beautifully loved.

Tuesday, March 05, 2013

The world is watching Kenya tonight. Monday was election day, the first under the new constitution, and the first since post-election violence five years ago claimed 1200 lives and displaced 60,000 people. Scott and I both covered call all day so our Kenyan colleagues could vote. And they did. The entire atmosphere was eerily hushed, few vehicles, few patients, everyone in long lines at polling stations, queuing for hours in the heat and dust of the dry season sun. After voting, our friends were calm, proud, determined, prayerful. Today we've been watching the long slow process of tallying the votes.

County by county, the results trickle in. In spite of numerous predictions that the race would be un-win-able in the first round, Uhuru Kenyatta, son of the country's first president, leads with 53%. He must win not only a simple majority but also at least 25% of the vote in at least half the counties (24/47). This is no small task as the country is divided starkly, with West and Coast voting for Odinga his historical rival, and Central ignoring the ICC criminal war-crime indictment and falling solidly behind Kenyatta. Still we have over half the votes still to be counted. So we all wait a bit nervously.

Yet as I watch the tally tonight, my mind is on the politics of eternity. At that feast, Uhuru Kenyatta and Rail Odinga will be mere footnotes. Seated in the places of honour will be the least-of-these heroines, my nominations for queens of Heaven.

PS came to us in casualty one day, where her father signed her in then disappeared. Abandoned. Before he left we gathered that this child had once been normal but had a catastrophic illness, perhaps meningitis. It seems the father works in the capital, and went to check on the family, found her in a condition of starvation and sores, felt horrified enough to load her in the car but desperate enough to panic and run. We weren't sure if she could see or hear; she could not certainly not walk or talk or sit or communicate. We think she is about 9 years old. In Kenya the options for an abandoned neurologically devastated malnourished child are not good. Various otherwise-caring people suggested to me that we put her in an ambulance and send her to the national hospital where we would also have to abandon her (they would not agree to accept her as a transfer). Or that there was nothing we could do other than find the same family that got her into this condition, and send her back. Or that we stop giving her any feeding or even fluids and let her die. Thankfully with the Needy Children Fund we worked out a plan to admit her for a week or so, hiring an attendant to help the nurses with her care, dressing her wounds and staving off her hunger. In that week we worked with the police (who did nothing), but were finally able to get in touch with a Sisters of Charity organization who agreed to take her. Thank God for Mother Theresa, for someone who stood for the value of touching the untouchables, caring for the most hopeless, as a ministry to Jesus himself.

MM is also nine. She was also a normal kid, until a "mad man" held her down and raped her when she was six, strangling her and damaging her trachea so badly she had to have a tracheostomy to breathe. By some miracle of childhood resilience she revived and was going to school with her trach (a small plastic tube in the front of her neck to keep her airway open) until a few months ago, when a classmate decided to pull it out. In the ensuing chaos of suffocation, she suffered severe brain damage before her airway was restored. Since then she has wasted away to skin and bones as her single mother struggles to cope. She convulses and moans, and I'm not sure how much awareness she has of what is happening around her now either. We're treating her infections and boosting up her nutrition too, on the no-child-should-feel-hungry principle even though a cure is not medically possible. Just trying to bring a measure of comfort and dignity in a life that has known too much suffering.

PS and MM, queens of Heaven. That's how I think of them as I round and prescribe and problem-solve. The glorious women that will someday emerge like butterflies from the chrysalis, the unimaginable way all this suffering will be redeemed. We see a shell of spasticity and weeping sores and raspy breath and uncomprehending eyes. God sees two women whom He will feel honored to seat on Jesus' right and left.

And when that happens, I hope Kenyatta and Odinga are at the table, but I suspect they'll be way down the line in the economy section with me.

Saturday, March 02, 2013

This past week Jack accompanied 16 other RVA students daily to Nairobi for the East Africa Model United Nations Conference. Nearly a thousand kids from Kenya, Tanzania, Rwanda, Uganda, and beyond congregated in the actual UN buildings (there are only 3 places in the world like this I'm told, though I can't remember the one that's not New York or Nairobi).

These kids were African, Asian, European, American, all hues and backgrounds, from those who grew up a stone's throw away to those whose parents are posted here on diplomatic or business purposes. They conducted a week of speeches, resolutions, debates, and parliamentary procedures. Each school was assigned a handful of countries or organizations to represent, and then their delegates were divided between four major sections of about 200+ each: politics, economics, ecology, and human rights, with a smaller number sent to a special session that debated a few specific and varied topics.

Jack was assigned to represent the IMF on the Human Rights committee. The resolution he wrote was chosen for recognition as best in his committee, and I'm told he spoke very well (let me testify that the boy can argue a point). He had designed a program for Columbia to combat the use of human mules in drug trafficking. RVA received 4 other certificates for speaking, so netted 5 of about 20 awards given. (that's Jack in the blue shirt below).

One of our students, Daniel Letchford, was Secretary-General and gave a very inspiring speech in the last session in front of the entire thousand people. He pointed out that only opportunity, not merit, separated the kids in the room from their neighbors all over Africa, and challenged them to make the most of those opportunities.

I was able to join the last day, Friday, as an observer, and am so glad I went. This is a microcosm of the world, and these students will be the very people who lead us into peace or war in the next decades. By meeting each other, they formed understanding and bonds. They learned to debate issues with logic and passion. They got a taste of the political process.

Particularly poignant and urgent as Kenya approaches elections in two days . . .

This is the whole RVA group in front of the UN sign. Tim Reber, principal and MUN sponsor, is in the back on the left.

The Human Rights committee, above and below.

This was as close up as I could get to Jack, blue shirt in center . . .

They also missed a week of school, so Jack's paying for that this weekend as he tries to catch up. Tomorrow he turns 15. We measured him at 6 feet 1 3/4 inches this morning. He just finished basketball season and starts rugby tryouts tomorrow; he writes creatively and aces precalc and physics; he thinks deeply about eternal issues. Whenever I think of how his life started, with me running from rebels and extremely ill with dysentery and high fevers in the first trimester of his gestation, I marvel that someone so robust could emerge from that inauspicious beginning. Grace, all grace.

Our Mission

who we are

paradox:
1. something that combines contradictory features or qualities.
Life in Africa is full of contradictions - the beauty and pain; the abundance and the poverty; the joy and the sorrow.
Our lives, too...dying that we might live; strong in our weakness; sinners yet saints.
2. a "pair of docs"